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the evolution of modern medicine(�峇�匳勞議處延)-及27何蛍

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!!!!隆堋響頼��紗秘慕禰厮宴和肝写偬堋響��




with the development of medical studies�察�Bologna and Montpellier。 At the 

former      the   study    of  anatomy      was    revived。     In  the   knowledge       of   the 

structure of the human body no advance had been made for more than a 

thousand       yearssince     Galen's     day。   In  the   process    of   translation     from 

Greek to Syriac�察�from Syriac to Arabic�察�from Arabic to Hebrew�察�and from 

Hebrew  or Arabic   to   Latin�察 �both   the  form  and   thought   of   the  old   Greek 

writers     were    not   infrequently   confused        and   often   even    perverted�察    �and 

Galen's   anatomy   had   suffered   severely   in   the   transmission。   Our   earliest 

knowledge   of   the   teaching   of   medicine   at   Bologna   is   connected   with   a 

contemporary          of   Dante�察    �Taddeo      Alderotti�察    �who     combined       Arabian 

erudition   with   the   Greek   spirit。   He   occupied   a   position   of   extraordinary 

prominence�察  �was   regarded   as   the   first   citizen   of   Bologna   and   a   public 

benefactor       exempt     from    the   payment      of   taxes。   That    he   should     have 

acquired wealth is not surprising if his usual fees were at the rate at which 

he   charged   Pope   Honorius   IV�察  �i。e。�察  �two   hundred   florins   a   day�察  �besides   a 

;gratification; of six thousand florins。 

     The   man   who   most   powerfully   influenced   the   study   of   medicine   in 

Bologna   was   Mundinus�察  �the   first   modern   student   of   anatomy。   We   have 

seen that at the school of Salernum it was   decreed that the human   body 

should   be   dissected   at   least   once   every   five   years�察  �but   it   was   with   the 

greatest difficulty that permission was obtained for this purpose。 It seems 

probable that under the strong influence of Taddeo there was an occasional 

dissection at Bologna�察�but it was not until Mundinus ��professor from 1306 

to   1326��   took   the   chair   that   the   study   of   anatomy   became   popular。   The 

bodies were usually those of condemned criminals�察�but in the year 1319 



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there   is   a   record   of   a   legal   procedure   against   four   medical   students   for 

body´snatchingthe         first  record�察  �as   far  as   I  know�察   �of  this   gruesome 

practice。 In 1316�察�Mundinus issued his work on anatomy�察�which served as 

a text´book for more than two hundred years。 He quotes from Galen the 

amusing reasons   why  a  man   should   write a  book�此   �Firstly�察�to   satisfy  his 

own friends�察�secondly�察�to exercise his best mental powers�察�and thirdly�察�to 

be saved from the oblivion incident to old age。; Scores of manuscripts of 

his work must have existed�察�but they are now excessively rare in Italy。 The 

book was first printed at Pavia in 1478�察�in a small folio without figures。 It 

was    very    often   reprinted    in  the  fifteenth   and   sixteenth    centuries。    The 

quaint   illustration   shows   us   the   mediaeval   method   of   teaching   anatomy�此�

the lecturer sitting on a chair reading from Galen�察�while a barber surgeon�察�

or an ;Ostensor�察─�opens the cavities of the body。 

     I   have    already    referred    to  the   study   of   medicine     by   women       at 

Salernum。 Their names are also early met with in the school of Bologna。 

Mundinus is said to have had a valuable assistant�察�a young girl�察�Alessandra 

Giliani�察�an enthusiastic dissector�察�who was the first to practice the injection 

of   the   blood   vessels   with   colored   liquids。   She   died�察  �consumed   by   her 

labors�察�at the early age of nineteen�察�and her monument is still to be seen。 

     Bologna honored its distinguished professors with magnificent tombs�察�

sixteen or seventeen of which�察�in a wonderful state of preservation�察�may 

still   be  seen    in  the  Civic    Museum。      That    of  Mundinus      also   existsa 

sepulchral      bas´relief    on    the   wall   of   the   Church     of   San    Vitale    at 

Bologna。��19�А�

     ��19�А  �For   these   figures   and   for   points   relating   to   the   old   school   at 

Bologna      see   F。  G。  Cavezza�此    �Le   Scuole    dell'  antico   Studio    Bolognese�察�

Milano�察�1896。 

       The other early mediaeval university of special interest in medicine is 

that   of   Montpellier。   With   it   are   connected   three   teachers   who   have   left 

great names in our storyArnold of Villanova�察�Henri de Mondeville and 

Guy  de   Chauliac。 The   city  was   very  favorably  situated   not   far   from   the 

Spanish border�察 �and   the receding   tide  of the Arab   invasion in the  eighth 

century had left a strong Arabic influence in that province。 The date of the 

origin of the university is uncertain�察�but there were teachers of medicine 



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there   in   the   twelfth   century�察  �though   it   was   not   until   1289   that   it   was 

formally founded by a papal bull。 

     Arnold of Villanova was one of the most prolific writers of the Middle 

Ages。 He had travelled much�察�was deeply read in Arabic medicine and was 

also   a   student   of   law   and   of   philosophy。   He   was   an   early   editor   of   the 

Regimen Sanitatis�察�and a strong advocate of diet and hygiene。 His views 

on disease were largely those of the Arabian physicians�察�and we cannot see 

that he himself made any very important contribution to our knowledge�察�

but   he   was   a   man   of   strong   individuality   and   left   an   enduring   mark   on 

mediaeval medicine�察�as one may judge from the fact that among the first 

hundred medical books printed there were many associated with his name。 

He was constantly in trouble with the Church�察�though befriended by  the 

Popes on account of his medical knowledge。 There is a Bull of Clement V 

asking the   bishops   to   search   for   a   medical book   by Arnold   dedicated   to 

himself�察    �but   not   many     years   later  his   writings    were    condemned       as 

heretical。 

     In   Henri   de   Mondeville   we   have   the   typical   mediaeval   surgeon�察  �and 

we     know    his   work    now     very   thoroughly      from    the   editions    of  his 

;Anatomy;   and   ;Surgery;   edited   by   Pagel   ��Berlin�察  �1889´1892���察  �and   the 

fine    French    edition    by   Nicaise    ��Paris�察  �1893��。    The    dominant     Arabic 

influence is seen in that he quotes so large a proportion of these authors�察�

but   he   was   an   independent   observer   and   a   practical   surgeon   of   the   first 

rank。 He had a sharp wit and employed a bitter tongue against the medical 

abuses of his day。 How the Hippocratic humors dominated practice at this 

time you may see at a glance from the table prepared by Nicaise from the 

works of de Mondeville。 We have here the whole pathology of the period。 

      

= 

     TABLEAU          DES     HUMEURS           D'APRES       H。   DE     MONDEVILLE 

Flegme   naturel。   F。   aqueux。   Flegme   F。   mucilagineux。   F。   vitreux。   Flegme 

non naturel F sale。 F。 doux。 F。 pontique�察�2 especes。 F。 acide�察�2 especes。 Bile 

naturelle。   Bile   B。   citrine。   B。   vitelline   Bile   non   naturelle   B。   praline。   B。 

aerugineuse。   B。   brulee�察  �3   especes。   Sang   naturel。   non   naturel�察  �5   especes。 

Melancolie             naturelle。         non          naturelle�察        �5         especes。 



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= 

 

     A still greater name in the history of this school is Guy de Chauliac�察�

whose      works     have     also   been    edited    by   Nicaise     ��Paris�察   �1890��。    His 

;Surgery;   was   one   of   the   most   important   text´books   of   the   late   Middle 

Ages。   There   are   many   manuscripts   of   it�察  �some   fourteen   editions   in   the 

fifteenth century  and thirty´eight   in   the sixteenth�察 �and   it continued to be 

reprinted far into the   seventeenth   century。 He   too   was   dominated   by  the 

surgery   of   the Arabs�察  �and   on   nearly   every   page   one   reads   of   the   sages 

Avicenna�察�Albucasis   or  Rhazes。  He  lays   down   four conditions   necessary 

for   the   making   of   a   surgeonthe   first   is   that   he   must   be   learned�察  �the 

second�察�expert�察�the third   that he should   be clever�察�and the fourth that   he 

should be well disciplined。 

     You will find a very discerning sketch of the relation of these two men 

to the history of surgery in the address given at the St。 Louis Congress in 

1904   by   Sir   Clifford   Allbutt。��20�А  �They   were   strong   men   with   practical 

minds   and   g
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